Provider Demographics
NPI:1427910009
Name:CONGENITAL HEART COMPASS MEDICAL PLLC
Entity type:Organization
Organization Name:CONGENITAL HEART COMPASS MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PRADEEPKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-340-7402
Mailing Address - Street 1:62 EMPIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-4356
Mailing Address - Country:US
Mailing Address - Phone:585-340-7402
Mailing Address - Fax:585-326-6129
Practice Address - Street 1:62 EMPIRE BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-4356
Practice Address - Country:US
Practice Address - Phone:585-340-7402
Practice Address - Fax:585-326-6129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-02
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Multi-Specialty
No207RA0002XAllopathic & Osteopathic PhysiciansInternal MedicineAdult Congenital Heart DiseaseGroup - Multi-Specialty